Healthcare Provider Details

I. General information

NPI: 1225958432
Provider Name (Legal Business Name): THRIVECLEARMIND LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58551 RIVER OAKS DR
NEW HAVEN MI
48048
US

IV. Provider business mailing address

43000 W 9 MILE RD STE 301
NOVI MI
48375-4129
US

V. Phone/Fax

Practice location:
  • Phone: 734-447-5285
  • Fax:
Mailing address:
  • Phone: 734-447-5285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: RICHARD COOPER JR.
Title or Position: MANAGING MEMBER
Credential:
Phone: 734-447-5285